Viewpoints: Solving the doctor shortage; Can Gov. Scott convince Fla. lawmakers to accept Medicaid expansion?

Apr 23 2013

The Washington Post: We Still Have A Health Care Spending Problem
With every new report about the recent slowdown in health-care spending there is speculation in the media that the problem of rising health costs has somehow been solved or cut down to size. ... The idea that we have licked the problem of health-care cost increases is no more probable today than it was in the past. Our nation has made no fundamental change in how health care is paid for or delivered (Drew Altman and Larry Levitt, 4/21).

The New York Times: How to Put America Back Together Again
Rebuilding our strength has to start with healing our economy. ... We're trying to put America back on a sustainable growth track that will expand employment, strengthen our fiscal balance sheet to withstand future crises and generate resources to sustain the most needy and propel the next generation. That requires three things: We need to keep investing in the engines of our growth ... We need to reform Social Security and Medicare so they can support all the baby boomers about to retire. And we need to raise more revenues (Thomas Friedman, 4/20). 

Los Angeles Times: An Rx For The Doctor Shortage
New subsidies and insurance regulations in the 2010 healthcare law are expected to bring coverage to millions of uninsured Californians starting next year. The newly insured are likely to put a bigger strain on the healthcare system, particularly in their demand for primary-care doctors, of whom there are already too few in many parts of the country. That's why trained medical professionals who aren't physicians, such as nurse practitioners, want more freedom to deliver the care they're capable of giving than state rules allow. Lawmakers should give it to them (4/21).

St. Louis Post Dispatch: Missouri Medicaid Expansion Is Too Important To Die
The Medicaid expansion effort is too important to allow it to be blocked, particularly for the Senate's specious reasons. Gov. Jay Nixon, a Democrat, has done his level best traveling the state, hand in hand with business leaders, most of whom have traditionally supported Republicans, to rally support for this important legislation. But it hasn't been enough. It's time for those business leaders to take a stand. Write some big checks for Democrats and see who comes running. Let Republicans like Mr. Lamping know that their careers are over if they don't get serious. ... Medicaid expansion isn't about Mr. Obama and it's not about some consultant-driven debate about future electoral success. The more people in Missouri who have health insurance, the fewer of them will die. This is literally a life-and-death issue (4/22).

Tampa Bay Times: Time For Scott To Get To Work On Legislature
Gov. Rick Scott has two weeks to demonstrate he can govern as well as he can issue press releases. It's great that the governor supports expanding Medicaid and accepting billions of federal dollars to provide health coverage to nearly a million residents. Now he has to persuade fellow conservative Republicans in the Legislature to agree or embrace a reasonable alternative. This is a defining moment for this state, and Scott should use all of the persuasive tools of his office to lead lawmakers to the right conclusion (4/19).

Forbes: Michigan's Legislature Resists Its Governor's Call To Approve Obamacare's Medicaid Expansion
Michigan's Republican governor, Rick Snyder, was among the many GOP state executives who made national headlines this winter by endorsing Obamacare's expansion of Medicaid, America's government-run health insurance program for the poor. But what isn't making headlines is that Michigan's legislature, like its counterparts in Florida, Ohio, and Arizona, is not going along (Avik Roy, 4/20).

Cleveland Plain Dealer: Still Hope For Ohio Medicaid Expansion
In a bipartisan move, the Republican-run Ohio House on Thursday kept alive Statehouse discussion of Medicaid expansion in Ohio. ... The amendment doesn't guarantee expansion, and in fact says that if no action is taken by Dec. 31 the subject is closed. But the House did, in effect, maintain Medicaid expansion as an open question. That represents a victory for Gov. John Kasich, who has proposed expanding Medicaid coverage in Ohio, and for the broad coalition of Ohioans who support expansion (4/20).

Bloomberg: Fix Immigration Bill To Reduce Health-Care Costs
Politicians have seldom talked about immigration reform and health-care costs in the same breath. With Congress debating legislation to remake the U.S. immigration system, perhaps it's time they did (Marta Tienda, 4/21).

Des Moines Register: Mentally Ill And Guns Are A Thorny Issue
After a week of madness and mayhem, explosions and poisoned letters, there was a moment of sanity last week in the U.S. Senate. Sadly, it was short-lived and quite possibly in vain. During debate on the ill-fated gun-control bill, senators passed an amendment 95-2 that was sponsored by Sens. Tom Harkin, D-Ia., and Lamar Alexander, R-Tenn. ... It expands federal programs related to mental health, including school programs aimed at early identification and intervention, suicide prevention, awareness training and substance abuse assistance. The idea is to spot warning signs and deal with problems long before anyone has to worry about whether a person can be trusted with a gun (Kathie Obradovich, 4/21).

Los Angeles Times: What California Should Learn From The 1-800-GET-THIN Saga
Today, 19 months after her death, we may finally have a good idea of what killed Paula Rojeski. According to a lawsuit and public autopsy records, the causes included her doing business with the 1-800-GET-THIN folks and the slicing of her aorta during weight-loss surgery at one of their affiliated surgical centers. There was also regulatory indifference on a truly majestic scale (Michael Hiltzik, 4/19). 

Forbes: Home Health Medicare Co-Pay: A Study In Unintended Consequences
The budget that President Obama submitted to Congress last week contains a call for, among other things, an increase of $1.4 billion in discretionary spending for the administrative expenses related to implementation of the Affordable Care Act (Obamacare). In a budget that claims to reduce the deficit, where is all this money coming from? Some of it -- $730 million -- is supposed to come from instituting $100 co-payments for Medicare patients who use home health care (Robert A. Book and Doug Holtz-Eakin, 4/19).

Boston Globe: Why Patients Don't Always Follow Doctor's Orders
Medicine, as physician and literary scholar Abraham Fuks has pointed out, often borrows language from the military. Patients "battle" cancer, which "invades" bodily tissues, hoping for a "magic bullet." Similarly, doctors, unlike lawyers, architects, and accountants, give "orders." The implication seems to be that while a person who rejects advice from any other sort of professional is a discriminating consumer, someone who fails to follow a doctor's orders is foolish, self-destructive, or even insubordinate. Yet, patients do ignore doctor's orders, and much more frequently than physicians would care to acknowledge (Suzanne Koven, 4/22).

Boston Globe: Chronic Care At Walgreens? Why Not.
Walgreens, the country's largest drugstore chain, announced last week that its 330-plus Take Care Clinics will be the first retail store clinics to both diagnose and manage chronic conditions like asthma, diabetes, high blood pressure, and high cholesterol. The Nurse Practitioners and Physician Assistants who staff these clinics will provide an entry point into treatment for some of these conditions. ... But the Walgreens announcement was met with skepticism by physician groups like the American Association of Family Physicians. And there are certainly causes for concern, at least based on what we know so far (Ishani Ganguli, 4/22).

MinnPost: How Surveillance Cameras Can Improve Medical Care
As the video released Thursday of the two suspects in the Boston Marathon bombings make clear, the surveillance video camera is now a ubiquitous part of our lives. … Still, I was surprised to read in an essay published online Thursday in the Journal of the American Medical Association (JAMA) of how hospitals are using surveillance cameras, sometimes surreptitiously, to get their medical staff to improve care. And the cameras seem to work remarkably well for this purpose (Susan Perry, 4/19).